Transplantation of the liver in adults and children with fulminant hepatic failure

Vickers, Christopher; Neuberger, James; Buckels, J. A. C.; McMaster, P; Elias, Elwyn

doi:10.1016/s0168-8278(88)80475-6

Cited by 106 publications

(37 citation statements)

References 15 publications

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“…Despite the advent of orthotopic liver transplantation (OLT), the mortality rate attributable to FHF remains high, at 20% to 68% (1)(2)(3). Clinical and laboratory recovery predictors for children with FHF are limited.…”

Section: Introductionmentioning

confidence: 99%

Fulminant hepatic failure and serum phosphorus levels in children from the western part of Turkey

Öztürk¹,

Berktaş²,

Tunçel³

et al. 2010

Turk J Gastroenterol

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Section: Introductionmentioning

confidence: 99%

Fulminant hepatic failure and serum phosphorus levels in children from the western part of Turkey

Öztürk¹,

Berktaş²,

Tunçel³

et al. 2010

Turk J Gastroenterol

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“…1 Despite the advent of orthotopic liver transplantation (OLT), the mortality rate attributable to FHF remains high at 20% to 40%. [2][3][4][5] Given the scarcity of donor organs and the long waiting list for transplantation, identification of predictors of mortality is clearly an issue of central importance in the management of FHF.…”

mentioning

confidence: 99%

Serum phosphorus levels predict clinical outcome in fulminant hepatic failure

Chung

Sitrin

2003

Liver Transplantation

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“…1 The survival rate of patients with these conditions who undergo liver transplantation is in the range of 56% to 80%, [2][3][4] compared with the 15% to 20% survival rate of patients who do not undergo transplantation, even with improved medical treatment. 5 Because FHF is rapidly progressive and irreversible, the need for liver transplantation is urgent. The death rate of patients awaiting liver transplantation is as high as 40% 6 or 62%, 7 possibly as a result of the difficulty of obtaining grafts in a timely manner, given the relative shortage of cadaveric donors.…”

mentioning

confidence: 99%

Living-related liver transplantation for patients with fulminant and subfulminant hepatic failure

et al. 1999

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The prognosis for patients with fulminant (FHF) or subfulminant hepatic failure (SFHF) has improved since the introduction of liver transplantation. However, the death rate of patients awaiting liver transplantation is high, possibly because of the difficulty in obtaining grafts in a timely manner, given the relative shortage of cadaveric donors. Between June 1990 and June 1999, 106 patients underwent living-related liver transplantation (LRLT) at Shinshu University Hospital. Among them, 8 patients had FHF and 6 had SFHF; these 14 patients are the subjects of this report. The graft volumes (GV) ranged from 231 mL to 625 mL, corresponding to 35% to 105% of the recipients' standard liver volume (SLV). The postoperative courses of all donors were uneventful. Following liver transplantation, all grafts functioned favorably, with normalization of serum total bilirubin within 3 to 5 days and normalization of coagulation profiles within 4 to 7 days. Thirteen of the 14 recipients are still alive. The actuarial 6-month, 1-year, and 5-year survival rates were 100%, 90%, and 90%, respectively. In the present study, when the ratio of the GV to the recipient's SLV was more than 35%, the graft was able to support the patient's metabolic demand after liver transplantation for FHF or SFHF. Because of the urgent nature of liver transplantation in this clinical condition, concerns over informed consent may be even greater than for elective LRLT. Nevertheless, the high success rate and low donor risk may justify this option for pediatric patients, as well as for a limited population of adult patients suffering from FHF or SFHF. (HEPATOLOGY 1999;30:1521-1526.)The prognosis for patients with fulminant hepatic failure (FHF) and subfulminant hepatic failure (SFHF) has improved since the introduction of orthotopic liver transplantation. 1 The survival rate of patients with these conditions who undergo liver transplantation is in the range of 56% to 80%, 2-4 compared with the 15% to 20% survival rate of patients who do not undergo transplantation, even with improved medical treatment. 5 Because FHF is rapidly progressive and irreversible, the need for liver transplantation is urgent. The death rate of patients awaiting liver transplantation is as high as 40% 6 or 62%, 7 possibly as a result of the difficulty of obtaining grafts in a timely manner, given the relative shortage of cadaveric donors.Living-related liver transplantation (LRLT) has been developed as an alternative to cadaveric liver transplantation. To avoid ethical dilemmas in LRLT, including any potential coercion of the live donor candidates, we have pursued a strict policy of ensuring that the participants in LRLT are fully informed of all aspects and risks of the procedure before we obtain their consent. As favorable results for LRLT have accumulated, reluctance toward the procedure has gradually subsided. Given this success, it is worth considering LRLT for patients with FHF, provided that each situation is considered with special care because of the short amount of time...

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Transplantation of the liver in adults and children with fulminant hepatic failure

Cited by 106 publications

References 15 publications

Fulminant hepatic failure and serum phosphorus levels in children from the western part of Turkey

Fulminant hepatic failure and serum phosphorus levels in children from the western part of Turkey

Serum phosphorus levels predict clinical outcome in fulminant hepatic failure

Living-related liver transplantation for patients with fulminant and subfulminant hepatic failure

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